Ocena przydatności diagnostyki ultrasonograficznej w różnicowaniu zmian ogniskowych wątroby

Focal liver lesions constitute a group of various abnormalities. Considering the diversity of the cells building the liver, those lesions may depict a pathology of hepatocytes, biliary epithelial cells or vessel cells and therefore express various morphology in ultrasonography. The most common are a cavernous hemangioma and a simple cyst. Both of those tumours are easy to diagnose in ultrasound examination and do not require further diagnosis. Cystic echinococcosis is a rare parasitic disease. The infection occurs after eating parasite’s eggs. In the course of this disease, echinococcal cysts are formed and liver is the main target organ. The cyst may exhibit a morphology of a simple cyst and, as it evolves, a solid lesion. The diagnostics may cause difficulties, due to sonographic similarities to other lesions. Ultrasonography is the first diagnostic tool in hepatic lesions evaluation.Zmiany ogniskowe wątroby tworzą heterogenną grupę nieprawidłowości. Ze względu na mnogość typów komórek budujących narząd, ogniska te mogą stanowić patologię hepatocytów, komórek przewodów żółciowych lub naczyń, a przez to odzwierciedlać różnorodność morfologiczną w badaniu USG. Najczęściej występuje naczyniak jamisty i torbiel prosta. Obie te zmiany są łatwe do rozpoznania w ultrasonografii i nie wymagają dalszej diagnostyki. Bąblowica jednojamowa jest rzadką chorobą pasożytniczą. Do zakażenia bąblowcem dochodzi przez spożycie jaj pasożyta. W przebiegu choroby powstają torbiele bąblowcowe, a najczęstszym narządem docelowym jest wątroba. Torbiele bąblowca mogą mieć charakter torbieli prostej, a dojrzewając, przekształcają się w formy lite. Podobieństwo obrazów ultrasonograficznych zmian bąblowcowych do wszelkich innych ognisk patologicznych wątroby utrudnia diagnostykę choroby. Badanie USG jest pierwszym narzędziem w ocenie zmian wątrobowych

Guzy nowotworowe jamy brzusznej u dzieci — wyzwanie dla pediatry i radiologa

INTRODUCTION. The diagnostic imaging is an essential element of oncologic diagnostics. Its role in early identification of a neoplastic disease has a major impact on the following management. OBJECTIVE. The purpose of this study was to demonstrate the role of radiologic imaging in diagnosis of abdominal tumors in children. MATERIALS AND METHODS. We retrospectively evaluated diagnostic imaging examinations that were performed on a group of 86 children aged 4 days to 15 years who were diagnosed and treated between 2007–2016 in the Department of Pediatrics, Hematology and Oncology of the Medical University of Gdansk. Results. The accuracy of US was 77%, CT 81%, MRI 78%. US and CT were consistent in 49/59 patients, US and MRI in 34/40 patients, CT and MRI in 11/ 13 patients. All three methods showed the same result in 9/13 children. CONCLUSION. US evaluation of the abdomen is a highly accurate preliminary diagnostic tool. It should be performed as a first examination in every patient suspected of having an abdominal tumor. The following diagnosis ought to be based on CT and MRI. The final diagnosis can be made only on the basis of the histological evaluation of the tumor.WSTĘP. Badania obrazowe są nieodłącznym elementem diagnostyki onkologicznej, ich udział we wczesnym rozpoznaniu choroby nowotworowej ma znaczny wpływ na dalsze działania diagnostyczne. Cel. Przedstawienie roli badań radiologicznych w diagnostyce nowotworów jamy brzusznej u dzieci. MATERIAŁ I METODY. Retrospektywna analiza wyników badań obrazowych (USG, TK, RM) wykonanych u 86 dzieci w wieku od czterech dni do 15 lat, diagnozowanych i leczonych w latach 2007–2016 w Klinice Pediatrii, Hematologii i Onkologii GUMed. WYNIKI. Dokładność metody USG oceniono na 77%, TK — 81%, zaś RM — 78%. Zgodność badań USG z TK stwierdzono u 49/59 pacjentów, USG z RM u 34/40, zaś TK z RM u 11/13, natomiast jednomyślny wynik we wszystkich trzech metodach zaobserwowano u 9/13 pacjentów. WNIOSKI. Ultrasonograficzna ocena narządów jamy brzusznej jest wstępnym badaniem diagnostycznym o wysokiej dokładności i powinna być wykonywana w pierwszej kolejności u każdego chorego z podejrzeniem guza jamy brzusznej. Poszerzenie diagnostyki powinno opierać się na metodzie RM i TK. Jedynie na podstawie wyniku badania histologicznego guza można ustalić ostateczne rozpoznanie

Wczesna diagnostyka choroby nowotworowej u dzieci

Nowotwory wieku dziecięcego stanowią w Polsce jedynie 0,5% nowych zachorowań na chorobę nowotworową. Charakteryzują się odmienną budową histologiczną niż w populacji osób dorosłych, a tym samym inną symptomatologią kliniczną. Mimo to, nawet w przypadku pojawienia się objawów mało charakterystycznych dla choroby nowotworowej lekarz pierwszego kontaktu powinien wziąć pod uwagę możliwość wystąpienia procesu nowotworowego i rozważyć skierowanie pacjenta do poradni onkologicznej. Forum Medycyny Rodzinnej 2010, tom 4, nr 6, 431-43

Odległe następstwa leczenia nowotworów złośliwych u dzieci

W ostatnich latach dzięki intensywnej skojarzonej terapii przeciwnowotworowej zwiększa się liczba dzieci wyleczonych z choroby nowotworowej. W związku z powyższym wzrasta liczebność populacji, u której obserwuje się późne następstwa samej choroby nowotworowej oraz jej terapii

Multiple primary cranio-spinal tumours in a 13-year-old female with neurofibromatosis type 2 management strategy

# The Author(s) 2010. This article is published with open access at Springerlink.com Introduction Neurofibromatosis type 2 (NF2) is an inherited, rare autosomal dominant syndrome characterised by the development of multiple benign cranial and spinal tumours, peripheral neuropathy, ophthalmological and cutaneous lesions. Herein, we report one case of NF

Ostatecznie gruźlica, a nie choroba nowotworowa. Prezentacja trzech przypadków pediatrycznych

Gruźlica wieku dziecięcego należy obecnie w krajach wysoko rozwiniętych do rzadkości. W pracy zaprezentowano przypadki trojga dzieci z objawami nasuwającymi podejrzenie choroby nowotworowej, u których ostatecznie dzięki interwencji chirurgicznej rozpoznano gruźlicę (węzłowo-płucną, wielonarządową oraz ściany klatki piersiowej). Tylko u jednej pacjentki uzyskano potwierdzenie bakteriologiczne. Objawy gruźlicy wymagają różnicowania z chorobą nowotworową. Chirurg, który pobiera materiał diagnostyczny, powinien pamiętać o wykonaniu badań bakteriologicznych w kierunku gruźlicy. Forum Medycyny Rodzinnej 2010, tom 4, nr 6, 464–47

Adrenocortical tumours in children and adolescents: The EXPeRT/PARTNER diagnostic and therapeutic recommendations

Adrenocortical tumours (ACTs) are rare during childhood. A complete surgical resection provides the best chance of cure, but the role and efficacy of the adjuvant therapy are still controversial. Various histologic criteria of malignancy for ACTs adopted in children do not facilitate comparative studies and are not completely shared. Therefore, a sharp demarcation between benign and malignant lesions has not been recognised, making it difficult to identify who potentially needs perioperative therapy. This manuscript presents the internationally harmonised recommendations for the diagnosis and treatment of ACTs in children and adolescents, established by the European Cooperative Study Group for Paediatric Rare Tumours (EXPeRT) group within the EU-funded project PARTNER (Paediatric Rare Tumours Network - European Registry)

Is there an association between hereditary hemochromatosis and colon cancer in children?

Colon cancer is very rare in children and adolescents, so it remains in an advanced stage at diagnosis. Hereditary hemochromatosis (HH) is an autosomal recessive disease in which iron overload leads to dysfunction of several organs. Elevated body iron stores has association between HFE genotype and risk for some types of cancer. There are HFE gene mutations, including the C282Y and the H63D mutation in the majority of individuals with phenotypic hemochromatosis. The HFE gene mutations may predispose to an increasing risk of colon cancer. Careful clinical and colonoscopic evaluation in patients with these mutations may lead to detect cancer at an earlier stage. We report a case of adenocarcinoma of the colon in 17-year old male with HH and risk of gastrointestinal cancer in patients with hemochromatosis gene mutations.Colon cancer is very rare in children and adolescents, so it remains in an advanced stage at diagnosis. Hereditary hemochromatosis (HH) is an autosomal recessive disease in which iron overload leads to dysfunction of several organs. Elevated body iron stores has association between HFE genotype and risk for some types of cancer. There are HFE gene mutations, including the C282Y and the H63D mutation in the majority of individuals with phenotypic hemochromatosis. The HFE gene mutations may predispose to an increasing risk of colon cancer. Careful clinical and colonoscopic evaluation in patients with these mutations may lead to detect cancer at an earlier stage. We report a case of adenocarcinoma of the colon in 17-year old male with HH and risk of gastrointestinal cancer in patients with hemochromatosis gene mutations

Association between intestinal and antioxidant barriers in children with cancer

Objective: Reactive oxygen species (ROS) play a role in cancerogenesis processing and damage tissues. Furthermore, oncological treatment may impair proper function of the gut barrier. The aim of this study was to measure intestinal permeability in children in clinical remission for solid tumours and to search for a possible relationship between free radicals and the intestinal barrier. No such investigation in children has been reported so far. Research Methods and Procedures: The prospective study consisted of 19 paediatric patients with cancer after completion of chemotherapy. 32 healthy children from the outpatients clinics were recruited for measurement of intestinal permeability and antioxidant barrier as a control group. Intestinal permeability was assessed by measurement of urinary lactulose and mannitol after oral challenge. Antioxidant enzymes: superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in erythrocytes were assessed. Ischemia modified albumin (IMA) concentration was measured in serum. Results: Cancer patients excreted less mannitol and more lactulose versus controls. The ratio of lactulose to mannitol was significantly higher in oncological children vs control (mean 0.188 and 0.0453, respectively, p=0.0006,). Significantly higher IMA level in the oncological group vs control was noted (mean 123.8 and 87.3 U/ml, respectively, p=0.0037). No correlation between intestinal permeability and oxidative stress barrier was found. Conclusions: Our data shows that intestinal barrier is damaged in paediatric cancer patients after chemotherapy. IMA is believed to play a protective role in the defence against tissue damage. No correlation was found between these two barriers

Thymoma and thymic carcinoma in children and adolescents: A report from the European Cooperative Study Group for Pediatric Rare Tumors (EXPeRT)

BACKGROUND: Thymomas and thymic carcinomas belong to a group of thymic epithelial tumours arising from the anterior mediastinum and, are extremely rare in children in which no therapeutic guidelines have been established. The aim is to describe paediatric characteristics of these tumours and give some therapeutic indications. METHODS: Retrospective analysis of clinical data and therapeutic characteristics of paediatric patients less than 18years with thymic tumours treated between 2000 and 2012 registered in the European Cooperative Study Group for Pediatric Rare Tumors (EXPeRT) database of the cooperating national rare paediatric tumour working groups from France, Italy, Germany and Poland. RESULTS: Sixteen children with thymoma, median age 11years and 20 patients with thymic carcinoma, median age 14years were enrolled into study. At diagnosis complete primary resection was possible in 11 patients with thymoma and one with thymic carcinoma; resection with microscopic residue was performed in three cases and incomplete resection with macroscopic residue in four patients. Chemotherapy with various regimens was administered to 22 children; 17 of them as neoadjuvant chemotherapy. Eight patients with thymic carcinoma received additional radiotherapy. Seventeen children died (15 thymic carcinoma, two thymoma). Five-year overall survival for patients with thymic carcinoma is 21.0\ub110.0%. CONCLUSIONS: This study confirms the possibility to perform European retrospective analysis even in very rare paediatric tumours. Thymic carcinoma is associated with paediatric patients to give a very poor prognosis independently despite multimodal management. Multidisciplinary, multicenter approach and collaboration with adults' physician are necessary in order to propose homogenous guidelines